Term
| What muscle is involved in Torticollis? |
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Definition
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Term
| What condition is described as Tilting of the head to one side w/ limited ROM, Can rotate head away from midline, but not towards, Neck pain, Vertigo or dizziness? |
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Definition
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Term
| What is the treatment for torticollis? |
|
Definition
Stretching exercises
Soft or Hard Collar (In Books, but not neccessarily in practice)
Surgery (Fuse C1 - C2), Release SCM
RX - NSAIDs and Muscle Relaxers
Pt Ed - No vigorous sports |
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Term
| What are the risk factors for herniated discs? |
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Definition
Frequent Heavy Lifting (with poor technique)
Diving into pool
Cigarette Smoking
Obesity |
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Term
| What are the S & S of a Herniated neck Disc? |
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Definition
| Neck Pain, Shoulder pain, UE weakness, pain or paresthesias |
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Term
| What may be the findings on physical exam of a patient with a herniated disc in the neck? |
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Definition
+ Spurling test
Possiblbe + Babinski's reflex
Decreased sensation and reflexes (esp in UE) |
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Term
| What is the treatment for patients with disc herniations in their neck? |
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Definition
PT: traction & exercise
NSAIDS
Muscle relaxants
Rest: activity modification
Surgery (Spinal Fusion - with multi-level dx) |
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Term
| What are the MC symptoms of a Cervical Sprain/Strain? |
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Definition
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Term
| What is the MC cause of a cervical sprain? |
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Definition
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Term
| What are some common causes of a cervical strain? |
|
Definition
Working at low computers
Position during sleep |
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Term
| What are the imaging techniques that should be used for a cervical sprain/strain? |
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Definition
Plain film: AP, Full lateral, open mouth (C1 & C2), swimmer’s view (C7)
CT/bone scan – R/O fracture |
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Term
| What are the treatment options for cervical sprain/strain? |
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Definition
Short period rest, soft collar
NSAID
Muscle relaxants
Ice x48 hrs, then heat
ROM exercises
PT consult |
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Term
| If a cervical fracture is suspected, what imaging techniques should be done? |
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Definition
| Plain film: AP, Full lateral, open mouth (C1 & C2), swimmer’s view (C7) |
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Term
| Which type of C2 fracture is a fracture of the tip of the odontoid? |
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Definition
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Term
| Which type of C2 fracture is a fracture of the base of the odontoid? |
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Definition
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Term
| Which type of C2 fractures are Medical Emergencies? What treatments do they require? |
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Definition
Type II and III
Halo and Surgery |
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Term
| Which type of C2 fracture is a fracture of the body of the axis? |
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Definition
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Term
| What are the S & S of Cervical Osteoarthritis? What is seen on Physical Exam? |
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Definition
Neck discomfort w/ motion (decrease in ROM)
Stiffness
Loss of function
On Physical Exam:
Decreased ROM
Joint effusion
Deformity |
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Term
| What imaging is used to diagnose cervical osteoarthritis? |
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Definition
AP & Lateral
MRI – to r/o neoplasms |
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Term
| What is the treatment for osteoarthritis? |
|
Definition
NSAIDS
PT: ROM exercises
Ortho or Neurosurgeon Consult |
|
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Term
| What are the S & S of cervical stenosis? |
|
Definition
Pain: neck or UE
Decreased ROM |
|
|
Term
| What imaging is used to aid in the diagnosis of cervical stenosis? |
|
Definition
|
|
Term
| What is the treatment for cervical stenosis? |
|
Definition
PT – ROM exercises
Ortho or Neurosurgeon consult |
|
|
Term
| What are the MC causes of traumatic cervical spine dislocation? |
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Definition
| MVA, diving, blunt trauma |
|
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Term
| What are the MC causes of atraumatic cervical spine dislocation? |
|
Definition
|
|
Term
| What are the signs and symptoms of cervical spine dislocation? |
|
Definition
Neck pain after trauma
Muscle weakness or parathesias |
|
|
Term
| What specific physical exam tests should be done for cervical spine dislocation? |
|
Definition
Spinous process “step off”
Motor: C4-T1 (C4 – diaphragm)
Reflex & Sensory exam |
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|
Term
| What imaging is used to aid in the diagnosis of cervical spine dislocation? |
|
Definition
|
|
Term
| What is the treatment for cervical spine dislocation? |
|
Definition
Keep collar on
Emergency consult to orthopedics or neurosurgeon |
|
|
Term
| What is the MC musculoskeletal condition? |
|
Definition
|
|
Term
| What are the risk factors for a pt developing back pain? |
|
Definition
Smoking
Manual labor
Obesity
Accidents
M > F |
|
|
Term
| What are the S & S of back pain? |
|
Definition
Back stiffness
Low back discomfort
Numbness
Paravertebral muscle spasm
Motor weakness
Decreased DTR
Decease nerve sensation |
|
|
Term
| What imaging should be done if the CC of a pt is back pain? Why? |
|
Definition
Plain films – NL
CT – NL
MRI – r/o disc herniation |
|
|
Term
| What is the treatment for back pain? |
|
Definition
Rest 1-2 bed rest, then light activity (back to work)
Heat – NO sleeping with heating pad
NSAIDS x4-6 weeks – drug of choice
Muscle relaxant
PT – walking, recumbent bike, swimming
Lifting & back care training (sitting & lumbar support) |
|
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Term
| What are Weddell sign's used for? |
|
Definition
| Method to identify malingering or non-organic back pain. |
|
|
Term
What are the "Can't Miss" with back pain?
TUNA FISH |
|
Definition
Trauma: loss of strength or balance
Unexplained weight loss or night sweats
Neurological signs: incontinence, night pain
Age > 50
Fever, malaise
Intravenous drug use
Steroids for long time
History of cancer or malignancy |
|
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Term
| If a pt complains of low back pain, bowel or bladder incontinence and saddle anesthesia, what condition should you suspect? |
|
Definition
|
|
Term
| How is Cauda Equina Syndrome treated? |
|
Definition
|
|
Term
| What is the MC cause of Brown-Sequard's Syndrome? |
|
Definition
|
|
Term
| If a pt has a penetrating trauma and has S & S including Low back pain, Loss of motor function, position, vibratory, & light touch of the affected side, Sharp & temperature lost on opposite side, what condition should you suspect? |
|
Definition
|
|
Term
| How is Brown-Sequard's treated? |
|
Definition
| It is a surgical emergency |
|
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Term
| What signs are found on imaging with a pt who has Scheuermann’s Kyphosis or Senile Kyphosis ? (4) |
|
Definition
Discs are flattened & irregular
Anterior longitudinal ligament – thickened
Vertebral bodies are wedged
Iliac crest – Risser’s sign |
|
|
Term
| What are some signs and symptoms of Scheuermann’s Kyphosis or Senile Kyphosis? |
|
Definition
“Poor Posture”
Hamstrings - tight |
|
|
Term
| How many degrees of curvature is pathologic for scoliosis? |
|
Definition
|
|
Term
| What is the treatment for scoliosis in a pt with lateral curvature of 10 - 25 degrees? |
|
Definition
|
|
Term
| What is the treatment for scoliosis in a pt with lateral curvature of 25 - 45 degrees? |
|
Definition
|
|
Term
| What is the treatment for scoliosis in a pt with lateral curvature of > 45 degrees? |
|
Definition
|
|
Term
| Where is a herniated disc more common? |
|
Definition
|
|
Term
| What are the S & S of a herniated disc in the lower back? |
|
Definition
Low back pain
Decreased motor strength
Decreased reflex
Decreased sensory |
|
|
Term
| How is a diagnosis of a herniated disc confirmed with imaging? |
|
Definition
|
|
Term
| What is the treatment for a disc herniation in the lower back? |
|
Definition
Cauda equina syndrome – immediately to surgery
Rest
NSAIDS
Muscle relaxant
PT consult
Epidural steriods
> 6 weeks - surgery |
|
|
Term
| What is the MC cause of Spondylolisthesis? |
|
Definition
| Most common cause is long standing spondylolysis |
|
|
Term
| A failure of what part of the vertebrae causes Spondylolisthesis? |
|
Definition
|
|
Term
| What grade on the Meyerding's scale is a slippage of < 25%? |
|
Definition
|
|
Term
| What gradeon the Meyerding's scale is a slippage of 25% - 50%? |
|
Definition
|
|
Term
| What grade on the Meyerding's scale is a slippage of 51% - 75%? |
|
Definition
|
|
Term
| What grade on the Meyerding's scale is a slippage of 76% - 99%? |
|
Definition
|
|
Term
| What grade on the Meyerding's scale is a complete displacement? |
|
Definition
|
|
Term
| What is the treatment for Spondylolithesis? |
|
Definition
| Ortho Consult - Grade II through V or any with symptoms are sent to treatment |
|
|
Term
| What part of the skeleton does ankylosing spondylitis most commonly affect? |
|
Definition
|
|
Term
| What is the MC presentation of ankylosing spondylitis? |
|
Definition
|
|
Term
| If a pt presents with signs and symptoms including Pain > 3 months, Insidious onset, Stiffness w/o pain, Malaise, Fatigue, Pain – in hips or buttocks 1st, AM pain that improves with exercise, Kyphosis, what condition should you suspect? |
|
Definition
| Ankylosing Spondylitis/Marie-Strumpell arthritis |
|
|
Term
| How does ankylosing spondylitis show up on plain films? |
|
Definition
|
|
Term
| What is the treatment for ankylosing spondylitis? |
|
Definition
Rheumatology consult
PT – exercise
Indomethacin – drug of choice
Well balanced diet |
|
|
Term
| What lab findings are characteristic of ankylosing spondylitis? |
|
Definition
ESR – elevated
HLA-B27 = + |
|
|
Term
| What are the signs and symptoms of spinal stenosis? |
|
Definition
Back pain, increased w/ sitting
Flexion decreases pain
Sciatica |
|
|
Term
| What is the treatment for spinal stenosis? |
|
Definition
|
|
Term
| If a pt has symptoms including Pain with weight bearing or joint motion, Stiffness, Loss of function (heavy work, tie shoes, walking), what condition should you suspect? |
|
Definition
|
|
Term
| What is the treatment for osteoarthritis? |
|
Definition
NSAIDS
PT – activity modification
Surgery |
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|
